Sound Medicine -- June 7, 2003

Hosts Barbara Lewis and Dr. Ora Pescovitz talk to physicians and researchers about:

Musician Injuries

Racial Disparities in Health Care

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Musician Injuries

"Playing hurt" is not only a condition for professional athletes. Professional musicians, whose "team" is a symphony orchestra, can have career threatening injuries as well. Many professional musicians play for countless hours and work in an atmosphere of perfection and competition. Just like other experts striving to stay at the top of their chosen field, it is not uncommon for musicians to play with severe pain.

Cellist Janet Horvath is the author of Playing (less) Hurt: An Injury Prevention Guide for Musicians. The book describes her two decades of work investigating musician injuries. Ms. Horvath joined the Minnesota Orchestra as associate principal cello in 1980 after two seasons in the same position with the Indianapolis Symphony. She received a bachelor's degree at the University of Toronto and a master's degree at Indiana University.

Musicians' injuries usually affect soft tissue, so they often do not appear on standard tests. In many ways, they are similar to computer-related injuries. Furthermore, many musical instruments require awkward physical positions, which result in injury after years of repetitive motion. Other common injuries include nerve entrapments similar to Carpal Tunnel Syndrome, back problems, and neck and shoulder injury resulting from simply holding an instrument.

Ms. Horvath offers some tips for musicians to lessen the chances of injury. It is important to keep moving, as static positions prohibit air from circulating in muscles. Musicians also must release their muscles when there is a chance to rest. Furthermore, it is important to do warm up exercises both with the instrument and away from it. Finally, musicians should vary their repertoire, rather than focusing on one technical skill for long periods of time.

Resources:

Learn more about Playing (less) Hurt.

The Musicians' Wellness website contains resources about seminars, support groups, events, and research.

The American Music Therapy Association advances public awareness of the benefits and access to music therapy.

More information and tips about musicians' injuries.

Racial Disparities in Health Care

Racial disparity has been recognized as one of the most challenging problems facing the U.S. health care system today. In fall 2002, the U.S. Department of Health and Human Services awarded $85 million to state and local organizations to support the elimination of health disparities among racial and ethnic groups. Only two years ago, the National Institutes of Health created the National Center on Minority Health and Health Disparity to conduct and support research, foster emerging programs, disseminate information, and reach out to minority groups, in an effort to eliminate health disparities. Dr. Tom Inui, President and CEO of the Regenstrief Institute in Indianapolis and Associate Dean for Health Care Research at the IU School of Medicine, puts these matters into perspective.

Racial disparity includes differences in prevention, access to care, and treatment, although Dr. Inui believes the most decisive factor is the socioeconomic divergence in access to care caused by differences in insurance coverage. Nevertheless, even within the same systems of health care, there are still differences in the quality of care received by minority and white majority populations.

Some health-related vulnerabilities are related to race. For example, African-Americans tend to be more susceptible to hypertension and high blood pressure than the general population. Similarly, Asian Americans appear to be less vulnerable to prostate cancer, but more vulnerable to certain kinds of kidney disease. Nevertheless, there are still differences in the quality of care that people receive for the same conditions, and this is what Dr. Inui finds unacceptable.

Having a diverse population of students in medical schools would hopefully alleviate many problems of discrimination. If educational settings are multicultural and multiracial, future health professionals will become exposed to the values and beliefs of other groups, and disparities in treatment would be less likely to occur.

Resources:

The National Center on Minority Health and Health Disparities promotes minority health and strives to reduce and eliminate health disparities.

View a press release from the Department of Health and Human Services

Read a book about racial and ethnic disparities in health care.

Is there a medical topic you'd like us to cover? Reach us by email: soundmed@iu.edu
or by phone:
(317) 274-4848.

Chronic exposure to the sun can lead to skin cancers, the most fatal of which is melanoma. Who should be most cautious about exposing themselves to the sun?

A.Residents of the midwest
B. Fair-skinned people
C. People who have never had sunburns

Find out!

Thousands of people have been quarantined and many more are playing it safe by sporting masks to cover their mouths and noses. This is because the SARS virus is dangerous and infectious. What is it about viruses that make them infectious?

Find out!

Exposure to lead at levels lower than 10 micrograms per deciliter (mcg/dl) - currently considered acceptable by the Centers for Disease Control and Prevention - may lower children's intelligence, according to a study presented at the Pediatric Academic Societies annual meeting and published in the New England Journal of Medicine.

Study researchers followed 172 children in Rochester, N.Y., from ages 6 months to 5 years, measured blood-lead levels every six months, and administered the IQ test at ages 3 and 5.

Researchers found that children with a lead concentration of less than 10 micrograms per deciliter of blood scored an average of 11.1 points lower than the mean on the Stanford-Binet IQ test. They also found an average 5.5-point decline in IQ for every additional 10-microgram increase in blood-lead concentration.

Inhaling lead-paint dust and eating paint flakes were the main causes of lead poisoning in children, until it was banned in 1978. Yet, approximately 434,000 children younger than 6 still have blood-lead levels above the current federal standard.

Sources:

More information on the study from Cornel News, the Division of Extramural Research and Training, and CNN.